Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen · 2026
[Quality indicators from the S3 guideline on palliative care for patients with incurable cancer: Identification of documentation processes, data sources, and challenges in palliative care units].
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Glizner Alexandra, Schade Franziska, Frerichs Hannah Verena, Stiel Stephanie, van Baal Katharina
Аннотация
BACKGROUND: Routine documentation in inpatient palliative care units takes up a significant amount of caregivers' workload, but at the same time offers many opportunities for data use, e.g. for quality assurance. The S3 guideline on palliative medicine formulates eleven quality indicators (QIs). It is currently unknown how or to what extent QIs are documented on palliative care units.
METHOD: Semi-structured planning interviews were conducted at seven palliative care units in the catchment area of the Comprehensive Cancer Center of Lower Saxony to determine the extent to which routine documentation contains data sources for measuring ten of the eleven QIs. The documentation systems, data sources and assessments used were recorded and compared with regard to the individual QIs of the S3 guideline on palliative medicine, at the same time identifying challenges in documentation.
RESULTS: There is no explicit documentation of all QIs across palliative care units, and the fulfilment of QIs can only be determined secondarily from routine documentation. For all seven palliative care units, the data sources are the baseline palliative care assessment, assessments such as MIDOS, IPOS or individual instruments, the progress documentation in text form and the letter from the attending physician. Challenges regarding documentation include duplicate documentation of content, technical difficulties, and inconsistent documentation procedures of different caregivers.
DISCUSSION: Routine documentation in palliative care units is heterogeneous. To determine compliance with the ten QIs, different data sources must be used for each palliative care unit, which makes comparisons between palliative care units difficult. The challenges mentioned above influence the use of data for scientific purposes. In research projects, sufficient time should be allowed for the use of pseudonymised secondary data, in particular to enable data protection coordination.
CONCLUSION: Documentation in palliative care units provides important data sources for measuring QIs, and at the same time, scientific analysis is subject to many limitations. Further research is needed to identify which aspects can motivate the implementation and systematic documentation of QIs.
METHOD: Semi-structured planning interviews were conducted at seven palliative care units in the catchment area of the Comprehensive Cancer Center of Lower Saxony to determine the extent to which routine documentation contains data sources for measuring ten of the eleven QIs. The documentation systems, data sources and assessments used were recorded and compared with regard to the individual QIs of the S3 guideline on palliative medicine, at the same time identifying challenges in documentation.
RESULTS: There is no explicit documentation of all QIs across palliative care units, and the fulfilment of QIs can only be determined secondarily from routine documentation. For all seven palliative care units, the data sources are the baseline palliative care assessment, assessments such as MIDOS, IPOS or individual instruments, the progress documentation in text form and the letter from the attending physician. Challenges regarding documentation include duplicate documentation of content, technical difficulties, and inconsistent documentation procedures of different caregivers.
DISCUSSION: Routine documentation in palliative care units is heterogeneous. To determine compliance with the ten QIs, different data sources must be used for each palliative care unit, which makes comparisons between palliative care units difficult. The challenges mentioned above influence the use of data for scientific purposes. In research projects, sufficient time should be allowed for the use of pseudonymised secondary data, in particular to enable data protection coordination.
CONCLUSION: Documentation in palliative care units provides important data sources for measuring QIs, and at the same time, scientific analysis is subject to many limitations. Further research is needed to identify which aspects can motivate the implementation and systematic documentation of QIs.